Treponema pallidum (VDRL) CSF with Reflex to Titer

Brief Description

Specimens will be screened for the detection of reagin antibodies. Reagin antibodies are non-treponemal antibodies produced by the body's defense mechanism in response to an infection with Treponema pallidum. If the VDRL is reactive, a quantitative titer will be done. 

Laboratory Unit

Immunology

Methodology

Micro-Flocculation

Specimen Collection

Minimum of 1 mL of cerebrospinal fluid collected by lumbar puncture
Collect in a clean, dry tube without any anticoagulant

Storage/Transport

Store freezer pillows in freezer for at least 24 hours prior to shipping with specimens.
Store specimens in refrigerator (2–8°C) after collection.
Specimens should be sent daily or next working day.
Transport in provided MSPHL shipping containers with freezer pillow(s).
Specimens must be received in the laboratory within 5 days after collection.

Acceptable Specimen Type(s)

CSF(cerebrospinal fluid)
A serum specimen needs to accompany the VDRL - CSF. Only if the Syphilis TP is reactive, will the VDRL be performed. If the specimen is from a patient 2 years of age or younger, the VDRL will be performed even if the Syphilis TP is non-reactive.

Test Request Form(s)

Immunology Test Request Form
Instructions for completing the Test Request Form

Possible Results

Reactive
Non-Reactive
Test Cancelled/Unsatisfactory

Unacceptable Conditions

Severely Hemolyzed Specimens
Specimen is not labeled with the patient’s name or 2 unique identifiers
Quantity Not Sufficient
Not received within 5 Days of collection
Sample transport conditions failed to meet acceptability criteria during accessioning

Interfering Substances

Hemolysis and bacterial contamination

Result Reported

Batch testing is performed weekly.

Fees

N/A

CPT Codes

86592 VDRL; if reflexed, add 86593 VDRL titer

LOINC/SNOMED Codes

VDRL:  5290-2
VDRL Titer:  31146-4

Additional Information

Biological false positive reactions occur occasionally with the carbon antigen (RPR) from individuals with a history of drug abuse, or with diseases such as lupus erythematosus, malaria, vaccinia, mononucleosis, leprosy, viral pneumonia, and after smallpox vaccinations.  Pinta, yaws, bejel, and other treponemal diseases produce positive reactions in this test.  A final diagnosis should not be made on the result of a single test, but should be based on a correlation of test results with other clinical findings.